Autogynephilia (IPA: /ˌɔtoʊˌɡaɪnəˈfɪliə/) (from Greekαὐτό (self), γῦνή (woman) and φῖλία (love) — "love of oneself as a woman") is a paraphilia proposed in 1989 by Ray Blanchard, who defined it as "a man's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman." [1]

It is part of a controversial behavioral model for transsexual sexuality informally known as the Blanchard, Bailey, and Lawrence theory. The model is an attempt to explain transwomen (male-to-female transsexual and transgender persons) who are not exclusively attracted to males, including lesbian (or "gynephilic"), bisexual and asexual transwomen. [2] The model claims that transwomen (called "gender dysphoric males" by Blanchard [3]) who are not sexually oriented toward men are instead sexually oriented toward the thought or image of themselves as women. Most of the attention paid to Blanchard's work on gender dysphoria focuses on what he calls "nonhomosexual transsexuals" or "autogynephilic transsexuals." He calls those transwomen who are exclusively attracted to males "androphilic" or "homosexual transsexuals."

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Controversy

The model is highly controversial and conflicts with the commonly accepted model of gender identity disorder. Some suggest that, since correlations do not establish causality, Blanchard may be mistaking a symptom of gender dysphoria for its primary cause. [4] A lack of control groups in Blanchard's work lead some to wonder how different bisexual, lesbian and asexual transsexual women are from bisexual, lesbian and asexual cisgender women. Blanchard has stated he considers a transwoman who has had vaginoplasty to be "a man without a penis." [5]Also, because Blanchard's clinic at the Clarke Institute turned down about 98% of all gender variant applicants during the time they controlled government funding, [6][7] many have asked whether that led to approval for more applicants who fit his model. Similar criticisms have been leveled against gatekeepers using other models.

The model has also been questioned on the grounds that it does not properly account for the behavior and self-identification of a great many transsexual and transgender women. Proponents of the concept have asserted that "autogynephiles," persons who are assumed to fit this model, are willfully deceiving others in claiming to exhibit behaviour that does not fit within it. [8]J. Michael Bailey, a notable proponent, quotes Clarke Institute employee Maxine Petersen as saying "most gender patients lie" and he himself claims that "the most common way that autogynephiles mislead others is by denying the erotic components of their gender bending" (pp. 172–173).[9] In addition, he has claimed that "Blanchard has shown in a couple of clever studies that nonhomosexual transgender patients who deny autogynephilia still show evidence for it." [10] The motivation for transgender and transsexual people who may not feel open to discussing these matters during diagnosis by gatekeepers has not been investigated by the model's proponents; critics of the model claim that these people are under pressure to report certain "correct" symptoms in order to navigate legal and medical protocols. The assertion that any transperson who claims not to fit into this framework must be "lying" has been widely criticized as making this model unscientific because it becomes unfalsifiable.

Another criticism of the theory of autogynephilia is that it defines gender dysphoria as a strictly sexual phenomenon. That is, it assumes that transwomen feminize their bodies in order to fulfill a sexual fetish. This does not stand up to scrutiny, as the effects of testosterone-blocking medications (and later, removal of the testicles) reduces libido in many transwomen and thus, transitioning in an attempt to fulfill a sexual desire would ultimately be counter-productive and those pursuing it for that purpose would likely reverse their trajectory as soon as this counter-productivity became apparent.

Sexual fantasies

It has been reported widely in clinical and lay literature that some people have sexual fantasies about being the other sex. These people may or may not also be transgendered. When viewed as a psychosexual pathology, these fantasies are considered a type of paraphilia.

Blanchard classified four subtypes:

Transvestic autogynephilia: arousal to the act or fantasy of wearing women's clothing

Behavioral autogynephilia: arousal to the act or fantasy of doing something regarded as feminine

Anatomic autogynephilia: arousal to the fantasy of having a woman's body, or parts of one [11]

Transmen

Transmen, that is female-to-male transgender persons, are only briefly mentioned by Blanchard. According to him, all transmen are of the "homosexual" type, that is attracted to women, since, according to proponents of the theory, "all paraphilias occur exclusively (or nearly exclusively) in men," and homosexuality would be considered a paraphilia (Bailey, 171). However, this is contradicted by reports of almost all transmen groups that at least one third of transmen are exclusively attracted to men, and that many consider themselves bisexual or similar.

Acceptance by some transwomen

A small minority of transwomen have accepted this diagnosis as an adequate description of themselves. Reasons for the acceptance of this theory can be:

The predecessor of the current gender dysphoria model, a theory that could be called the transsexual/transvestism model (i.e the Benjamin Scale), practically prohibited any sexual feelings related to cross-dressing or cross-living (or at least the revelation of these feelings) for the diagnosis of transsexualism, which in turn was necessary for medical treatment. The autogynephilia model lumped "male gender dysphorics, paedophiles and fetishists" into a group that can be considered for this diagnosis as transsexual because of their "erotic target location error" [12]

Because Blanchard's model makes no distinction in sexuality between transsexualism and transvestism, some who would have previously been diagnosed as "transvestitic applicants for sex reassignment" find this conflation validating and a step up in social acceptability from being "just a crossdresser" to "more than a crossdresser."

The current mental illness diagnosis of gender identity disorder allows for sexual feelings related to cross-gender feelings, and also distinguishes far less rigidly between "transsexuals" and "transvestites" than its predecessor.

Critics point out that those who embrace this model as an identity are participating in their own pathologization. Other transsexual and transgender people who describe erotic elements to their feelings take issue with Blanchard's terminology because it diagnoses a psychosexual pathology. It also claims this erotic element is the primary explanation and the motivating force. Further, critics note that there is no evidence that differential diagnosis based on sexual history leads to higher satisfaction rates among clients of trans health services.

The pathologization of socially unacceptable erotic interests has a long history, and recent clinical diagnoses such as "ego-dystonic homosexuality" and "nymphomania" have fallen into disrepute. Critics of the model expect "autogynephilia" will similarly be eventually discredited as a diagnosis.

An example of a transwoman who accepts this designation would be Ann Lawrence.